We have experienced a case of renal cell carcinoma with multiple pancreatic metastasis 7 years after operation for the primary foci which was successfully removed by a total pancreatectomy.
A 65-year-old man was admitted to the hospital because of an abdominal tumor. There were previous histories of undergoing a left nephrectomy for left renal cancer (pT2N0M0, stage II) in November 1989; and undergoing removal of subcutaneous metastases in the left buttock and right upper arm during observation wihile he was administered oral 5FU in Mat 1993. Thereafter IFN-α at a dose of 25, 000, 000 units per 2 weeks had been administered. In January 1996, dorsal percutaneous metastasis occurred and was removed, when he was found to have an abdominal tumor as well. He was referred to the department with a suspicion of pancreatic tumor. Four metastatic foci extending the entire pancreas were diagnosed and a stomachpreserving total pancreatectomy was made iMarch of the year. In the resected material, four tumors with the diameters of 5.5, 2.0, 1.0, and 0.8cm respectively were present which were histologically diagnosed as pancreatic metastases of renal cell carcinoma. The patient's postoperative course was uneventful and he was discharged from the center. However, multiple hepatic metastasis occurred 16 months after the pancreatectomy and he died in April 2000.
Although pancreatic metastasis of malignant tumor rarely occurs and has a poor prognosis, pancreatic metastasis of renal cell carcinoma can be a candidate for operation and be expected to have a good prognosis.